Why are we still not getting pregnant?

Could a micronutrient deficiency be stopping you conceiving?  NFC Nutritionist Dr Jane Jamieson (PhD) examines the issue.

The patients I see at the Natural Fertility Centre are looking to improve their health and increase their chances of either conceiving naturally or through IVF.  Some people have specific issues – male sub-fertility for example, or low AMH. Very commonly I see an imbalance of hormones and thin endometrial lining. 

Women usually seek out nutritional help of their own accord.  Most, but not all, men have been persuaded or coerced by their partners and many couples are referred to me from my colleagues at the centre. As a nutritional therapist I am more likely to see couples than most of the other complementary therapists and this makes perfect sense.  Nutritional therapy impacts the sperm and the egg equally and good nutrition for both ensures the best possible embryo with the greatest chance of success. 

Generally people try to eat fairly healthy diets and this is a great starting point for nutritional therapy.  However, many people are often unaware of what a healthy diet really consists of for their specific needs. Patients might increase their intake of fruit and try to cut out refined sugars in biscuits and alcohol but will not be as aware of the need to add in nutrients.  Because of this, many of these patients still struggling to conceive.  

Reaching optimal fertility needs a multi-faceted approach.  The basics are: a healthy diet, regular exercise and good sleep which all lead to balanced hormones.  Sometimes these can all be in place but conception is still elusive.  This is when we look at deficiencies of micronutrients. Very often people are taking in enough nutrition for their every day needs however, if they have been depleted for a period of time, they will need an enhanced programme and specific supplementation to counteract their deficiencies. 

There are two types of nutrients - macronutrients and micronutrients.  Macronutrients are the foundations of a healthy and fertile body.  They include carbohydrates, proteins and fats.  These need to be eaten in the right ratios dependent on a patient's lifestyle and underlying genetic make-up.  In a consultation I help people work out what their optimal balance needs to be.

Micronutrients are nutrients that the body needs, in very minute amounts, in order to function optimally.  They are the catalysts that help the body work most efficiently and effectively. They include vitamins (eg. C or E); minerals (eg magnesium and calcium); trace elements (eg chromium and copper), phytochemicals and antioxidants. Understanding where your body is lacking and addressing your specific needs can make the difference between having a successful outcome and almost being successful. 

Micronutrient deficiency becomes even more of an issue when the couples are older and whilst they may have a great diet now, that may not have been the case in their 20’s or 30’s when they were training, or working hard and playing hard! It all needs to be taken account of. 

My job as a nutritional therapist is to pin down deficiencies in micronutrients that may be causing difficulties with fertility and conception.  It’s a complex business and requires an in-depth knowledge of chemistry and biology but the deficiencies are usually obvious to the trained eye and can be put right through a combination dietary advice, targeted supplementation and lifestyle interventions.  

They key is finding out why the deficiencies arise – is it due to lack of a certain micronutrient in diets (eg not enough iron in vegetarian diets) or due to problems with absorption because of digestive issues?  For example, patients with IBS are often lacking in micronutrients as the gut doesn’t have time to absorb them before they are expelled by the body.  Stress also causes the body to use up its resources much more quickly than normal, so leaves you deficient in enough nutrients to help fertility.

Very often, I recommend a Hair Mineral Analysis which highlights deficiencies and give me a precise guide on which changes to recommend to a patient, but the aim is always to make it practical and manageable for you.  Sometimes dietary changes seem be daunting, depending on where your starting point is, and patients either go for it full throttle or make smaller, incremental changes.  Whichever way you want to go, these improvements can make a huge difference to your health and your fertility and also gives your baby the best start in life. 

 

Exploitative IVF 'Add-on's'? We disagree.

Both The Times and The Telegraph have today printed details of a BMJ report on exploitative methods used by IVF clinics in the UK and these were followed by a BBC Panorama programme which has only left our patients more confused and disorientated than before.

Ok, so they might be right about London where competition is fierce and prices are high, but we disagree about clinics here in Scotland.  We know we're not over-endowed with IVF clinics up here but the ones we do have are mostly good and are patient, rather than money, focused.  NHS IVF clinics, generally, do not offer many, or any, 'add on's' such as Assisted Hatching or PGD (except where genetic disorders are present).  Most will offer Blastocyst transfer, which I would suggest is now the norm rather than an 'add on', and Uterine 'scratching' but we know from many years experience that they don't by any means push these on patients. 

The one private clinic of note in Scotland, the GCRM (based in Glasgow but with satellite clinics in Dundee and Edinburgh),  are very careful with what they advise couples.  Our experience with them is that they look very carefully at the research and only recommend a treatment or technique if they think there is enough evidence to support it.  We sometimes get frustrated when we read about, and have patients who successfully try, other interventions (such as immune system testing, which the GCRM is now providing) in London or abroad, but we appreciate that clinics here proceed with great care and we value that integrity.

From the perspective of our patients, we know many like to gain a wider perspective and have the options laid out in front of them.  Here at the clinic we see it as part of our job to inform people about what's available both in the UK and abroad. Sometimes, a couple is happy not to find out more and would rather just go with what they've been offered but we're always here to provide information about alternative clinics or techniques to interested patients.

The BMJ also says in its report, that IVF is often offered to patients who don't need it and this we have found to be true.  Conventional 'bio' medicine sometimes seems to bypass what we see as common sense and go straight to interventionist options.  We have seen many, many couples where an irregular menstrual cycle, overwork (leading to high levels of stress hormones) or missing the time of ovulation is really all that's going against them and, although IVF can overcome the first and last of these, it need not be the first point of call.  I have spoken to IVF nurses who say the same .... many of the couples they see do not actually need IVF at all.  On the other hand, we have seen couples who, despite all the fantastic nutrition, acupuncture and other 'complementary' interventions, do not go on to conceive naturally but do conceive with IVF.  In those cases, you can be sure that there is some physical or hormonal barrier which remains un-diagnosed but which IVF overcomes.

So all in all, we would say this BMJ report has some value if it makes patients more aware of being led up the garden path by unscrupulous clinics but, here in Scotland, our experience is that add-ons are carefully considered and offered in appropriate circumstances.

'It's Stat time of year again!' or 'Not just a bunch of numbers'

I'm not sure what's happening to me.  On the Business Management HND course I did when I was 19, statistics were my most dreaded subject, along with accounts.  Now however, that they seem to have a purpose and Excel has been invented (yes, it was that long ago), I actually really enjoy the number crunching.  It's amazing what you can glean from a full spreadsheet of figures and it does really feel like 'data mining' - digging into the rock face of figures staring at me on the screen and finding those gems.   

What's also lovely is seeing patients' names again - patients we treated way back in 2012. I remember them and the stories they told me, both happy and sad,  over the time they came into the clinic.  These memories give even a flat excel spreadsheet a warmth and richness of detail.

Of course, I understand that not many people out there get as much excitement from this as I do but I'm hoping that sharing our results means you can make informed decisions - whether or not it's worth coming to see us, for example - and whether you feel happy telling struggling friends about what we do.  Not only that of course, the data  also helps us keep track of how we're doing and, I'm very pleased to say, that our results/success rates have been consistently high since we started keeping track effectively (2012).

Here are some simple stats to get you in to the groove:  

40% of our patients are using, or have used, ART (Assisted Reproductive Techniques) including IVF, ICSI, Egg donation and Sperm donation.  That means, of course, that 60% are trying naturally.

22% of patients have had either one or more miscarriages.

14% of patients have been told they have 'unexplained infertility' and 12% have a Male Factor issue.

Importantly:  38% of the total number of patients we have seen since 2012 went on to conceive. That's from everyone, whether we actually know their results or not - when we don't know the outcome we record no pregnancy, although actually experience has shown us that people often have been successful but have just moved on in their lives and haven't remembered to tell us.  Even better, of the 43% (359 people) from whom we have results, 85% have conceived.

Despite the excitement of number crunching, it's the patient's stories the shine through most in this exercise.  Each little '1' in the 'pregnant' column is an overwhelming joy for you and a shout of jubilation for us. Each '0' in the same column is a deep sigh and a willingness to re-group, construct a new plan and to make things better next time.  We share so much of your lives in the precious sessions in the clinic: some people want to chat, others want to close their eyes and lie still, but there is always an interchange of stories and ideas, which certainly enriches our lives and, hopefully, yours as well. 

Seeking the thin blue line - a personal blog

Blog post 1

 

I’m 33. My partner and I are trying for a baby. A family. It’s proving much trickier than we thought.

The lovely ladies at The Natural Fertility Clinic are supporting us and they’ve asked me to share my journey with you. It’s a very personal one. It’s not one I’m sharing with many people and I'm finding it lonely. I’d spoken to Rachael about reaching out for support from the Clinic’s community, I let slip that I write, and we came up with this idea.

These are all my own thoughts, my experiences. They may reflect your own, they may not. You may disagree with what I say, how I’m handling things. Or something I write may reach out to you and make you feel you’re not so alone. Ultimately I’m hoping that by sharing something intimate that impacts so greatly on me everyday, but that is rarely talked about, that I’ll feel less alone too.

I’ll be publishing this blog regularly so please look out for it and comment, share, like, connect with me - and please be kind - thanks. Daisy

Fertility vs Fertility

If you look up the word 'fertility' in a dictionary it will give you two definitions: 1. the ability to conceive children or young and 2. the quality of being fertile or 'productiveness'.  Synonyms for this last definition include: fruitfulness, productiveness and prolificacy. 

The article, Redefining our own fertility - and then realising we never lost it in The Huffington Post puts an emphasis on the this second definition of fruitfulness and productiveness and suggests that we have lost sight of this more general and generous aspect of Fertility.   The author describes older women, in their 50's, 60's and 70's, who are enjoying a full life; exploring aspects of creativity beyond reproduction and childbearing and encourages us to discover and nourish our productive selves.

Working from within the fertility industry we tend to see only one side - that concerning reproduction.  We witness the many patients who come looking for support and treatment when conception is either delayed, or, further down the line, improbable without medical help.  It is easy to forget that there is a wider role for men and women as fertile beings in life. 

In our role as supporters of sub- or in-fertile women and men, we should also encourage them to explore and develop the other fertile sides to their lives.  Whether through sport, adventure, art, self-development, writing or even the way they manage their lives, we can try to bring to each patients' attention their ability to express themselves, create and be fertile in many other ways.

Thank you letter from a happy patient

We often receive cards with thank you's and they're all kept proudly in a folder in our reception but are difficult to share online.  Here's an email we received from a happy patient which we can share easily with you all in the knowledge that many take hope from hearing other patient's stories. 

Hello
Just wanted to let staff who have been involved in our treatment know of your part in helping us to have a positive and successful journey so far...
Particularly wanted to extend our thanks, and ask you to share this message with Jill Storstein, Acupuncturist.
 We both had acupuncture treatments with Jill last Autumn, various dates through November.
We then had IVF treatment at GCRM in Glasgow in cold and wintry mid December last year, so just squeezed this in right before Christmas.
Our positive pregnancy result on 28 December, and later 8 week scan, all were promising.
Since then we have had one or two extra private scans, plus our NHS maternity scans also.
 Last week we had our 20 week scan and all is looking very well.
Baby is measuring right on target for a 3 September due date, and all physical development looking very healthy.
 We are so hugely grateful for all support from your centre, and the excellent treatment received from Jill.  This means the world to us.
We are now trying to relax and believe this will really happen this time, and now need to get busy with preparations and clearing out nursery space at home!
 We will of course update you in around 4 months, once the happy arrival joins us!"

We also had the additional acupuncture sessions immediately before and after embryo transfer. These were carried out by Alan Hunter in Glasgow, affiliated acupuncturist, who is experienced in working with GCRM patients at the clinic. Another incredibly supportive professional, and excellent treatment, which helped give us extra confidence at the crucial stage.

 "We hope that many other couples will feel encouraged on their journey, and confident in trying therapies available.  It is difficult to believe that things will stay positive, particularly after experiencing loss and heartaches in the past. However we feel we explored all options and did all the things we could within our means, to put ourselves in as strong a position as possible, and give ourselves best chances of succeeding. Luckily we sought out great care, and were fortunately blessed with good results."
 

Latest Testimonial

Here's a short testimonial from a past patient, now looking to conceive No.2.  We often hear back from patients who are ready to try again and it's lovely to welcome them back and catch up on all the news and life-changing experiences!

I have PCOS with very irregular periods. We’d been trying to get pregnant for over a year and I was taking clomiphene for ovarian stimulation, with increasing doses every visit to the ferility clinic. The urine tests were showing that with increasing doses it seemed to be working initially, then stop again. As a GP, I’d heard of acupuncture for fertility and thought it was worth a try. Rachel was a great therapist and I found it very interesting from the medical perspective too. After 1 month I got pregnant. I continued to attend in early pregnancy and I now have a beautiful baby girl.

The Heartache of Recurrent Miscarriage

Almost one quarter (22.5%) of our patients have suffered from miscarriage or recurrent miscarriage.  Of those, our records show that at least 45% do become pregnant again and most of those patients go on to give birth.  But what happens to those who don't stay pregnant and suffer one miscarriage after another?  

Lately, the number of women coming to us with recurrent miscarriage seems to have increased and these patients are experiencing anger, frustration and grief on an emotional level, as well as the aftermath of blood loss and surgery on a physiological level.   They feel alone - surrounded by friends or relatives either pregnant or with babies; ignored by the doctors - who insist that tests are only available once three miscarriages have occurred, and at a loss as to how to help themselves.

Mark Zuckerberg highlighted the tragedy of miscarriage last year with comments on Facebook about he and his wife's attempts to have a child.  After three miscarriages and then a successful pregnancy, he wrote:

It’s a lonely experience. Most people don’t discuss miscarriages because you worry your problems will distance you or reflect upon you. So you struggle on your own.

Loneliness does seem to characterise how the couple, and the individual, feels after a miscarriage.  Each pregnancy loss is a blow which most people do not want to share or discuss for fear of re-living the pain.  We very much understand and acknowledge a couple's, specifically the woman's, grief and loss, and try to provide a safe space to talk and be understood.  But we do, as a team, also try to help a couple communicate, find strength in each other and to look forward and visualise the possibilities.  

Partially, we do this by advising some practical steps. For example, we might recommend tests such as Hair Mineral Analysis, which can indicate abnormal levels of metals (like mercury, lead and aluminium - all very unhelpful in conception and pregnancy) in the body tissue.  The tests are relatively cheap to do and our nutritionist will go through the data with you and advise on ways to balance out the nutrients and eliminate toxins in the body (for both partners).   We also suggest private testing for those who don't want to wait for a third miscarriage.  Both chromosomal and blood clotting tests are available from private clinics.  Some patients have looked online and found information about immunological involvement - we can pass on information on clinics who offer testing for levels of Natural Killer Cells.  DNA Fragmentation testing is also available - offering a way to look at the involvement of the sperm in recurrent miscarriage which previously could only be guessed at. Research indicates that sperm DNA fragmentation could be a large factor in recurrent miscarriage. 

On the other hand, some patients are not ready to move forward and try again and our experience has shown us that sometimes just waiting, supporting and being there, is what that person needs most.  There is a huge fear and anxiety around trying again, which is wholly understandable and needs time - days, weeks, months -  to change into the courage to move on.  We also understand, and support the fact, that 'moving on' does not exclusively take the form of another pregnancy.  

Time to get your mojo back!

Recent research published on the Fox News website, has discovered that the more sex a woman has, at any time of the month, the more fertile she is, due to increased levels of specialist cells which help prepare her body for pregnancy.

Image: Fox News

Image: Fox News

The Fox News article states:

Researchers at Indiana University found that sexual intercourse, even when performed outside the window of ovulation, causes physiological changes in a woman’s body that make her more fertile.

The author of the study said that the research is the first to show that sexual activity may cause the body to promote types of immunity that support conception.  

Women's immune systems have a difficult task  - they have to  keep the woman safe by attacking diseases and infections but they also also need to recognise other types of foreign bodies, such sperm and embryos,  and leave them well alone.

There are two types of cell which help the woman in this task - 'helper T cells' which prevent the body from detecting the foetus and sperm as a foreign substance and 'Immunoglobulin G Antibodies' which are found in the blood and ward off disease without affecting the uterus.  Both these types of cells were found in greater numbers in women who had more sex during their cycle, meaning that those women had a greater chance of conception.

GP's regularly recommend that a couple have intercourse every 2 days when trying to conceive but this is because they assume that women are not able to accurately predict their 'fertile window.  In our experience, this advice can have a negative effect on couples, as the pressure to 'perform' (for the man and the woman) every two days is often too much to bear on top of busy work and social lives plus other commitments.  At the Natural Fertility Centre we teach women to be aware of the lead up to the fertile window, as well as the window itself but also emphasise the need to keep functioning as a sexually active couple throughout the month - for the sake of the relationship and communication on all levels.  Lately we have seen a few couples who have taken a break from actively trying to conceive in order to focus on their relationship, a decision which we applaud.  Getting your sex life back on track, or reassessing and revitalising your sexual relationship as a couple is vital to create a strong bond and improve your chances of conceiving.

Our Conception Coach, Dee Armstrong, is here on Mondays for women who want to learn more about identifying their fertile time.  For those couples who need help getting their mojo back, this book from YinOva director and author Jill Blakeway can be a useful guide and our counsellors, Gabrielle Moericke (Edinburgh) and Francesca Howell (Glasgow), can also give you expert support.  Sometimes small tweaks to your diet can make a huge difference as well - effecting mood and energy levels - and for those needing calm, acupuncture reduces adrenaline levels and helps to keep you relaxed and more able to enjoy life and enhance relationships.

Quantum Physics + Biology = Food State Supplements!

Traditionally, biologists have used the concepts in Newtonian physics to explain biological phenomena but this has never proved to be very satisfactory.  So I was delighted to watch Professor Jim Al-Khalili, in his series “The Secrets of Quantum Physics”, explore how quantum physics explains some of the mysteries seen in biological systems.

Episode 2 of his series “Let There Be Light” focusses on interesting problems which have never been satisfactorily explained before - questions like 'how do birds navigate so accurately?', 'how does chlorophyll capture light so effectively and transform it into physical matter?','how do enzymes work so efficiently?' and the 'mechanism of DNA mutation'. 

Newtonian physics describes how matter is constructed in simple terms and is easy to visualise and understand.  It is seductive in terms of using it to explain the natural world because it makes sense to our minds. Matter appears to our experience as solid and acts in a consistent manner and therefore Newtonian physics appears to describe how our world works. 

Quantum physics, on the other hand, can be quite difficult to bend our minds around as it describes our world as being made of particles which can either be in a state of a particle or a wave and can be both at the same time. It depends on what method we use to try and visualise these particles as to whether we see them as particles or waves. 

The exciting thing, to my mind, about using quantum physics to look at biological systems, is to imagine the interactions between different molecules occurring as vibrations (waves) rather than a physical entities.  This makes it easier to see how the energy that is contained within molecules affects how they interact. 

I had a kind of eureka moment, from watching some of his explanations, of how our receptors interact with molecules to give us our sense of smell and realised that this explains beautifully how synthetic molecules differ from biological ones. 

Biological molecules are in a higher energy state due to the amount of energy captured from the sun in the form of photons. As long they do not have too much physical processing applied to them, they remain in a high energy state when they are consumed which will affect the amount of energy they can give us and how good we feel when we eat these types of food. 

This explains why we feel better and do better on foods which are closer to nature such as wholegrain brown rice, compared to rice krispies. Rice krispies are ultimately based on rice grains but they have had all the nutrients processed out of them, using chemicals and high levels of heat, and goodness knows what else, and have had synthetic chemicals put back in, so that they can still be called food. 

You can easily prove the difference between these two “foods” to yourselves, by trying to eat a diet which consists solely of either rice krispies and water, or cooked brown rice and water. The first diet is very unsatisfactory to the body and would be difficult to sustain for any length of time.  The second, whilst being boring to the palate and the mind can be much more satisfying to the body and has been used as a great healing tool to assist digestive distress by many nutritional therapists.  

How do we apply this understanding to the differences between synthetic and natural or food state supplements? 

Most interactions that occur in biological systems occur through binding to receptors. That means binding to the receptors on cell membranes to trigger a reaction within the cell or binding to the receptor sites found within enzymes to allow chemical reactions to occur much more quickly. 

We can use the description given by Professor Al-Khalili of how our sense of smell works to understand that the bonds within molecules will vibrate at different rates depending on how the molecule is structured. The molecular bonds within a synthetic molecule will vibrate at a different rate than the molecular bonds found within food or foodstate molecules. This means that when the more natural molecules are attached to the receptor sites they will trigger a reaction more effectively and work more efficiently in the body. The net result of this is that natural foods and food state supplements are absorbed more effectively into the body, they are held onto for longer by the body and make a bigger difference to the biochemistry of the body. The end product of this is that that we get more energy, better hormone balance, improved digestive function and better immune system support. Over time this means restoring your body to a better state of health and this is why, as part of the Natural Fertility Centre, I developed our food state supplements. 

When you come to read this blog it is likely that the programme “Let There Be Life” by Professor Jim Al-Khalili may no longer be available on iplayer, however, it is still likely to be found on youtube and also Professor Jim Al-Khalili can be found on Ted Talks. His talks are always entertaining and illuminating. 

Dr Jane Jamieson PhD, Nutritionist, The Natural Fertility Centre

 

 

"Allowing the mother to breathe"

Image: The Telegraph

Image: The Telegraph

This is such a lovely, moving article by Amanda Revell Walton which was published in the Independent today.  It deals with a subject - childlessness - that most of our patients don't want to read or think about but I think it's important to acknowledge that for some couples childlessness is a reality.  Whether by choice or whether it's been forced upon them.

Revell Walton doesn't deal with the options of adoption or fostering but talks eloquently about allowing 'the mother' inside her room to breathe and develop through her love and care for others - partners, nephews and nieces, friends and pets.  

The article highlights the fact that the mothering aspect of ourselves doesn't need to atrophy just because we don't have children.  She says:

Not having children will not destroy you, or your life. I’m passionate about sharing my experience and showing that it is possible to live a positive life without children.

Being childless is just another path that perhaps you didn’t expect to be walking down, but one that can be equally fun, equally satisfying, and equally happy.

The article made me think of advice we often give to our female patients: make room in your life NOW for the child you so want.  Don't leave it until you're pregnant to make lifestyle changes.  If you haven't got time now in your work and social schedule, even for yourself, to relax and wind down, how are you going to find time for a child? 

This might sound a bit prescriptive but from a physiological point of view it makes so much sense.  If your body is in constant 'fight or flight' mode, which it will be if you are busy and working with deadlines (even if that deadline is 'I have got to empty the dishwasher before I go to bed'), then it is not going to be geared up for conception.  In order to conceive you need the right balance of hormones and constant high levels of stress hormones, such as adrenaline and cortisol, work against this by suppressing progesterone and narrowing blood vessels.

Making time in your life now to relax, de-stress and allowing your maternal aspect room to breathe and grow can only be a positive step.  Love and mother yourself and those around you - whether or not you are aiming to conceive your own child now or in the future.

June Case Study

We always ask patients for feedback and to write a testimonial or case study but we also recognise that there is little time left over with a new-born baby on the scene.  That is why we really appreciate when someone takes the time to do this, for us and for future patients.

Here's our latest case study/testimonial from RR, Edinburgh, June 2015: 

I attended the NFC after having three miscarriages over two years. We lost all babies in the first trimester.
At my first appointment I was recommended to have acupuncture and to meet a nutritionist. From this I went on and attended acupuncture monthly and adopted a dairy free diet.
Initially I hoped these treatments would work but had little faith as I felt I would never be able to maintain a pregnancy and was in a very negative frame of mind. I had acupuncture with Rachael regularly who created a lovely calm, friendly and supportive environment. My nutritionist was Jane who again was a brilliant support and very knowledgeable. I felt both professionals were generally interested in my health and wellbeing and wanted the best outcome for my husband and I.
After one month I became pregnant and maintained a healthy pregnancy. I now have a wonderful 6 month old baby girl. I feel having acupuncture and the changes to my diet had a massive contribution to my healthy pregnancy. I also felt great support and comfort from attending the NFC and I also believe this helped my pregnancy. I have remained on a dairy free diet and have noticed massive improvements.
I will always highly recommend the NFC to anyone going through difficulty. I believe I had a successful pregnancy due to the help received and changes I made from your advice.THANK YOU SO MUCH!

Life Begins at 40

The Guardian today has a very well written and considered article on the perceptions around fertility and IVF.

Following comments by Consultant Gynaecologist Professor Geeta Nargund, a storm has once again arisen around women being advised to have children earlier and not to delay.

What the author of the Guardian article is arguing, is that there shouldn't be such an outrage whenever anyone points out a simple (but uncomfortable) biological fact. It's time we, and the media, realised and acknowledged that science and medicine cannot overcome every problem.  Our bodies - men's as well as women's - are designed to procreate and conceive most successfully under the age of 30.  We cannot force evolution to change its pathway, even over a few lifetimes, so the couples conceiving and carrying a healthy baby to term in their 40's are always going to be the exception rather than the rule.  We need to recognise that IVF still has a low chance of success and treatments like egg freezing are still in their early stages and also have a low success rate.

Years ago, I started writing a book around fertility for couples in their 40's.  It turned into a bit of a rant about society and how we are failing to support couples, generally, but women specifically, to have children when their bodies are most suited to that task.  Men need to be encouraged to reach maturity earlier.  Greater support is needed for women choosing to be single parents.  Girls and boys need to be taught, at school, that fertility is finite.

If nature was allowed to do what it does best then we would all have our children in our 20's with youth and vigour on our side.  By 40 couples would be free again of the demands of childcare and could look forward to a healthy and hopefully carefree, life ahead.

Quote from a happy patient

"I had my scan on Thursday and can't tell you how amazing it was to see this little miracle. I'm 13 weeks and 3 days, due 21st October. 
3 years, 3 miscarriages, no response to IVF, low AMH, and it still happened. Please pass my story on to any clients who this may help to stay positive. 
I'm sure your input helped this to happen so thank you again."

F.U. Edinburgh April 2015

Fashion faux pas

So what is the problem with Dominico Dolce and Stefano Gabbana commenting on their feelings regarding IVF?   After all, everyone is entitled to their own opinion aren't they?

As a specialist fertility acupuncturist who has treated hundreds of couples, gay and straight as well as single women, I can empathise completely with people who have been stung by the fashion duo's comments.  

There are two things going on here.  The first is that Dolce and Gabanna called babies conceived through assisted means 'synthetic' and the second is that they have also said that they oppose gay adoptions.

image: www.factorydirectcraft.com

image: www.factorydirectcraft.com

In the first instance, I think there is a misunderstanding stemming from the idea that people are choosing assisted reproduction over natural conception. That it's some sort of lifestyle choice.   In fact, the reality is that every couple would rather opt for some great, un-pressurised sex and a natural pregnancy every time.  Out of all the people I have treated, there has only been one couple who pro-actively chose IVF over natural conception and that was because the man involved travelled so much with his work that he was never around at the right time.

Of course, there are levels of intervention from chemicals to bring on ovulation to egg or sperm donation and surrogacy.  Most couples hope for the least medical help possible and move slowly along the list of available procedures until they at last have a successful pregnancy. Most are highly frustrated at needing any 'help' at all and search out alternatives or adjuncts such as acupuncture and nutrition. 

So here's a question,  if a man  increases his intake of selenium to improve his sperm does that also lead to a 'synthetic' child?  Would this also be altering the 'natural flow of life', as Dolce & Gabbana put it, any less than taking an egg and sperm and uniting them in a petri dish?

No one actively chooses IVF over natural conception, they 'choose' it over not having any kids at all.  They 'choose' it when there are no other options left to them. So to then find that their fought for and desperately desired children are referred to as 'synthetic',  after the battles, tears, heartbreak and disappointments, is like sticking a knife in and then giving it a good twist.

The second case - of same sex adoption may not be born of ignorance - Dolce and Gabanna being a gay themselves and possibly having considered their options on children in the past.   Who knows?  I'm not going to pronounce.   I just think it's wonderful that the option is there for all couples to adopt if they can and want to, whether they're gay or straight couple or a single parent.  

I once had a patient who was worried that her child, conceived through IVF, would be teased about it in the playground - an idea that I heartily dismissed at the time.  Dolce and Gabanna's words bring this mother's fears more to the fore.  Let's hope their comments are born of ignorance and misunderstanding rather than considered opinion.

"Oh, go on then" - the low down on drinking alcohol whilst 'trying'

I'm sure many of you have seen this article by now in the New Statesman - "Trying to get pregnant is hard enough without being told not to drink."  It seems to have generated a lot of interest on our Facebook page and hit a real nerve with patients.

Whether or not to give up alcohol is a question we are asked by patients all the time.  It's far worse at Christmas when parties and nights out are the norm rather than the exception, and also any time around weddings.  Outside of these times, it's easier to just refuse invitations and go to bed early than attend a function and have to find an excuse not to drink.

We always say "remember to have fun!".  As long as you're getting 80% of the lifestyle stuff right (especially nutrient intake and resting) then your body can usually deal with the 20% which might include alcohol, cake, chocolate, the odd bag of crisps or a day when you didn't drink much water or exercised to exhaustion.  You've got to still feel good about yourself, your life choices and your future - as women we are too good at criticising ourselves and not good enough at singing our own praises.

image: www.womansday.com

image: www.womansday.com

I know that scientists are trying to give good advice but, unless you have an alcohol addiction, there really are more important things to check first when faced with months of trying .... are your cycles regular, are you getting the right amount of nutrients, are you exercising sensibly and not to extremes, are you finding time to relax & forget about your 'to do' list, are you drinking a good amount of water and do you really know when your fertile time is (ie the signs your body show you rather than an app)?  In addition, is your partner doing all these things too?  Alcohol affects sperm in the same way as any other body cells so those couple of cans a night might need to be reconsidered - enjoyed on the occasional weekend rather than a nightly habit.

 Drinking alcohol is so much part of our lives that many people enjoy a glass or more every night - something our bodies can find hard to cope with.  We also tend to rely on alcohol to feel relaxed.  Give your body a chance by taking a break at least 4 nights of the week and drink sensibly rather than bingeing on those occasions.  When you have a drink, enjoy it and relish it as a treat.

What women (and couples) need is support, not admonition.  We need guidance rather than rules and the less finger-wagging there is, the better.  The key to it all is to enjoy the life you've got whilst looking forward to a life with a child.  Christmas, parties and weddings are part of our annual round of festivities and are important times to relax and enjoy.  If you want to have a few drinks whilst 'trying', then do and don't beat yourselves up about it afterwards.